Chapter 4766-2 Ambulances

(A)
"Board" means
the Ohio medical transportation board as described in section
4766.02 of the Revised Code.

(B)
"Headquarters" means the
location which a licensee operates, designated by the licensee as the location
where the records described in this chapter are maintained or readily
available.

(C)
"Medical
Transportation Organization (MTO)" has the same meaning as emergency medical
service organization as defined in division (H) of section
4766.01 of the Revised Code.

(D)
"Operate" means to engage in
conduct or activity in furtherance of the licensed activity at or from a
physical location owned, leased or maintained by the licensee where employees
report to work and vehicles or aircraft are stored. Operate also includes the
act of receiving a person within Ohio for transportation to a location within
Ohio.

(I)
"Reinspection Fee" means a fee required to conduct an
inspection as a result of the issuance of a notice of deficiency, also referred
to as a notice of non-compliance with a provision of Chapter 4766. of the
Revised Code or agency 4766. of the Administrative Code, by the board or its
designee, to a licensee or license applicant, regarding a permitted
ambulance/non-transport vehicle or an ambulance/non-transport vehicle for which
a permit application is pending.

(J)
"Temporary
Vehicle" means an ambulance or non-transport vehicle issued a temporary permit
used to replace a permitted ambulance or non-transport vehicle in accordance
with rule
4766-2-12 of the Administrative
Code that is out of service until the permitted ambulance or non-transport
vehicle is returned to service not to exceed sixty days.

(A)
A MTO applying for licensure shall file
with the board an application on the form prescribed by the
board,as published on the board's website at
http://omtb.ohio.gov/Forms/Form1.pdf, dated April 16, 2012, in the English language, and
shall submit the completed application to the board accompanied by the
appropriate fee as defined in rule
4766-2-03 of the Administrative
Code.

(B)
In addition to the
requirements set forth in section
4766.04 of the Revised Code, for
each application the MTO applicant shall provide:

(1)
The name,
organizational structure, and address of applicant
as
follows:

(3)
Highest level of service to be provided, service areas including county and state;

(4)
A list of the names
of all officers, directors,
and/or owners of the MTO;

(5)
The
name, address and physician license or
certificate number of the medical director as
and state of
licensure;

(6)
For each
satellite base, the MTO shall provide the street address, city, county, state,
and zip code;

(7)
The name of the
primary contact person, business or administrative office telephone number, and
if applicable, office fax number and e-mail address;

(8)
Year of manufacture, make, model, vehicle
identification number, odometer reading, license plate number (renewal only) of
each ambulance or non-transport vehicle to be permitted;

(9)
A color photograph of the side of
applicant's vehicle displaying color scheme,
insignia, monogram, or other distinguishing characteristic. If multiple color
schemes, insignias, monograms, or other distinguishing characteristics are
used, a color photograph of each must accompany application. (Digital
photographs are preferred);

(10)
A current certificate of liability
insurance in the name of the applicant listing
Ohio medical transportation board as a certificate holder with a thirty day
cancellation notice as specified in section
4766.06 of the Revised Code:

The actual name on the licensure application shall appear on
the certificate of liability insurance;

(C)
Each MTO shall pay the appropriate fees
as specified in rule
4766-2-03 of the Administrative
Code.

(D)
If an application for
licensure is incomplete, the board will notify the applicant that the
application will not be processed until it is complete. Such notification will
occur via certified mail one time for each submission.

(E)
The certificate of licensure issued by
the board shall indicate the highest level of service the MTO is authorized to
provide.

(F)
Licenses shall be
issued to MTOs who meet the criteria to provide the following levels of
service:

(B)
Each MTO shall pay a permit
fee for each ambulance or non-transport vehicle of one hundred dollars
annually.

(C)
Each MTO that shows
satisfactory evidence of compliance with section
4766.10 of the Revised Code
shall be eligible for the fifty percent fee reduction only for the ambulance(s)
or non-transport vehicle(s) operating within the municipality. The fifty
percent reduction applies to license fees, permit fees, and renewal fees but
does not apply to the inspection and reinspection fees.

(1)
To be eligible for reduction, the MTO
must show evidence of municipal license that meets or exceeds section
4766.10 of the Revised Code;

(2)
Each MTO shall declare the
number of ambulance(s) and non-transport vehicle(s) at each licensed location.

(D)
Each MTO shall pay
an inspection fee of one hundred dollars per ambulance or non-transport
vehicle.

(E)
Each MTO shall pay a
one hundred dollar reinspection fee for every ambulance or non-transport
vehicle that requires reinspection as a result of a deficiency issued by the
Ohio medical transportation board.

(F)
Each MTO shall pay a
temporary permit fee of one hundred dollar fee
for each temporary permit to be obtained.

(A)
The board
shall conduct initial and renewal inspections of all MTOs pursuant to Chapter
4766. of the Revised Code and rules
4766-2-04,
4766-2-05, and
4766-2-06 of the Administrative
Code to include the following:

(D)
The board may conduct routine unannounced
inspections at any location of licensed MTO at any time, including night or
weekend inspections to determine compliance with Chapter 4766. of the Revised
Code and agency 4766 of the Administrative Code to include, but not limited to,
the following:

(3)
A current
certificate of liability insurance issued by an insurer
licensed to do business in Ohio that includes a thirty day notice of
cancellation to the board in compliance with the terms set forth in section
4766.06 of the Revised
Code listing Ohio medical transportation board as a certificate holder
;

(4)
Current copy of the MTO's written policy
covering the use of warning devices;

(5)
Records or other documents related to
patient care or to emergency medical service personnel maintained by the
licensed MTO which shall be made available for review by the board;

Such records or documents shall be made available in
accordance with 45 C.F.R.
164.512 ;

(6)
Current maintenance records for vehicles as specified in rule
4766-2-09 of the Administrative
Code;

(7)
Current maintenance records for all
equipment used for patient care as specified in
rule 4766-2-09 of the Administrative
Code;

(A)
All licensed MTO dispatch centers shall be equipped with a base station capable
of two-way communications with associated mobile radios on an assigned
frequency. Cellular telephone with active two-way radio communication
capabilities is permissible. This channel will be used exclusively for
dispatch. The base station shall demonstrate and maintain voice communications
with the radios used in the permitted ambulance(s) and non-transport vehicle(s)
within the declared service area.

(2)
A hand held battery operated base station
used as primary source of communication is prohibited.

(B)
All permitted ambulance(s) and
non-transport vehicle(s) shall be equipped with two-way communications which
shall have the capability to communicate with the licensed MTO's dispatch
center and with medical control in the licensed MTO's service area.

(1)
Primary two-way communication devices
shall maintain either a one hundred ten-volt or twelve-volt power source backup
for each communication device;

(2)
All MTOs shall maintain a detailed radio log that documents the following:

(C)
If a MTO
contractually uses another communication center for dispatch purposes, the
communication center shall provide written certification of compliance with
Chapter 4766. of the Revised Code and agency 4766 of the Administrative Code as
applicable.

(B)
A licensed MTO shall ensure that
sanitation procedures are provided to all personnel in a written document that
conforms with current standards as set forth in occupational safety and health
administration-bloodborne pathogens protocol.

(C)
A licensed MTO shall maintain and follow
a written sanitation plan that conforms with the latest bloodborne pathogen standards as written by the
occupational safety and health administration. The following documentation
shall be maintained for each vehicle:

(D)
All licensed MTOs shall establish a
written policy governing the use of emergency lights and audible warning
devices pursuant to section
4511.24 of the Revised Code
which shall be made available for the board's inspection.

(2)
A MTO must demonstrate proof that the
ambulance(s) complies with all specifications set forth in the
current national
standard in effect at the date of manufacturing of the ambulance(s)
by one of the following:

(c)
Signed affidavit by the
manufacturer certifying
compliance with national standards in effect at time
the vehicle was manufactured.

(3)
The name of the MTO shall be permanently
affixed with each letter being a minimum of three inches in height on both
sides and each letter being a minimum of one and one half inches in height on
the rear of the ambulance or non-transport
vehicle.

(a)
If a MTO is under contract which requires other
signage, the MTO's name and service code shall be permanently affixed with each
letter being at a minimum of three inches in height on both sides and one and
one half inches in height on the rear of vehicle.

(4)
All board identified deficiencies must be
corrected. The vehicle shall be placed out-of-service until it passes
reinspection by the board.

(E)
Vehicles not titled as ambulances are not
eligible for permits as ambulances, but may be issued permits as "non-transport
vehicles" pursuant to section
4766.07 of the Revised Code,
provided they fall within the definition of such vehicles in division (Q) of
section 4766.01 of the Revised Code.

(F)
Upon issuance of a
vehicle permit, each licensed MTO shall apply the decal on the outside of the
right rear window in accordance with division (B)(2) of section
4766.07 of the Revised Code on
each ambulance and non-transport vehicle.

(H)
The board may conduct routine unannounced
inspections at any location of licensed MTO at any time, including night or
weekend inspections to determine compliance with Chapter 4766. of the Revised
Code and agency 4766 of the Administrative Code to include, but not limited to,
ambulance(s) and non-transport vehicle(s).

(I)
A permitted ambulance or non-transport vehicle
shall maintain compliance with roadworthy requirements set forth in this rule
at any time it is used as an ambulance or non-transport vehicle.

If a licensed MTO removes a permitted ambulance or
non-transport vehicle from service it shall place an "out of service" sign in
the permitted ambulance or non-transport vehicle to be visible through the
windshield with the following information included on the front of the sign:

(a)
Date permitted ambulance or
non-transport vehicle was taken out of service;

(b)
Odometer reading at time permitted
ambulance or non-transport vehicle was taken out of service;

(c)
Reason permitted ambulance or
non-transport vehicle was taken out of service;

(d)
Printed name and signature of person
responsible for taking permitted vehicle out of service;

(e)
The words "out of service" utilizing not
less than three inch lettering.

(3)
If a permitted
ambulance or non-transport vehicle is at a repair/maintenance shop that is not
owned or operated by the licensed MTO for maintenance purposes, no "out of
service" sign is required.

(1)
All licensed MTOs shall
ensure performance and maintain documentation of
all periodical maintenance and repairs of bio-medical equipment as required by
manufacturer and/or food and drug administration including but not limited to
the following:

(A)
Permitted ambulance(s) and non-transport
vehicles(s) bearing license plates issued under section
4503.49 of the Revised
Code are considered public safety vehicles pursuant to division (E)(1) of
section 4511.01 of the Revised
Code.

(B)
Permitted ambulance(s)
and non-transport vehicle(s), when responding to emergency calls, may use
emergency lights and audible warning devices pursuant to section
4511.041 of the Revised
Code.

(A)
In the event of a disaster situation when
permitted ambulance(s) based in the locality of the disaster situation are
incapacitated or insufficient in number to render services needed, a licensed
MTO may utilize whatever means necessary to transport and treat patients.

(B)
An ambulance or non-transport
vehicle that has not been issued a permit by the board may be
issued a
temporary permit, for
a period not to exceed sixty days, if the ambulance or non-transport vehicle is
used to replace a
permitted ambulance or non-transport vehicle that has been temporarily taken out
of service for repair or maintenance . In
order to obtain a temporary permit, a MTO shall submit a written application to
the board containing:

(1)
Vehicle
identification number of the permitted ambulance or non-transport
vehicle;

(2)
Date permitted
ambulance or non-transport vehicle was placed out of service;

(3)
Vehicle
identification number of the ambulance or non-transport vehicle to receive a
temporary permit;

(4)
Date temporarily
permitted ambulance or non-transport vehicle is to be placed in service;

(5)
Reason the permitted ambulance or non-transport vehicle was taken out of
service.

(C)
The
licensed MTO shall ensure that the one hundred dollar fee prescribed in
paragraph (F) of rule
4766-2-03 of the Administrative
Code shall be received by the board within seven days of issuance of a
temporary permit.

(D)
The MTO
shall note the date of return to service of the permitted ambulance or
non-transport vehicle on the temporary permit.

(E)
The licensed MTO shall return the
temporary permit to the board within two days after the permitted ambulance or
non-transport vehicle is returned to service.

(A)
Staffing
compliance for a MTO licensed as basic life support, intermediate life support
or advanced life support service shall be as follows:

(1)
A licensed MTO
that responds to a call for medical assistance or patient transport shall
ensure that in responding to the call, a minimum of one permitted ambulance and
two certified EMTs are dispatched and respond to the call.

(2)
A licensed MTO
that responds to a call for medical assistance or patient transport shall
ensure that any patient transport is done by a permitted ambulance staffed with
two certified EMTs on board.

(3)
When an
ambulance is so staffed as contained herein, the ambulance may be operated by a
person who is not certified as an emergency medical technician-basic, emergency
medical technician-intermediate, emergency medical technician-paramedic, but
said operator shall receive certification in an emergency vehicle operator
course prior to operating an ambulance.

(B)
Any non-EMS certified personnel who will
be driving the ambulance or non-transport vehicle shall complete an emergency
vehicle operator course that meets current requirements of the national highway
traffic safety administration.

(B)
Within ten days of
the date a permitted ambulance or non-transport vehicle is permanently
withdrawn from service, the licensed MTO shall return to the board a deletion
form prescribed by the board, as published on the
board's website at http://omtb.ohio.gov/Forms/Form12.pdf, dated April 16, 2012, and the decal from the right
rear window.

(C)
Within ten business days of the date a licensed
MTO ceases to operate, it shall return to the board all vehicle decals and the
certificate of licensure.

(D)
Within ten business days of the date a licensed
MTO ceases to operate a satellite base, it shall return to the board the
certificate of licensure.

(E)
A licensed MTO may apply at any time to be
licensed at a higher level. The application shall be made on a form prescribed
by the board, as published on the board's website at
http://omtb.ohio.gov/Forms/Form11.pdf, dated April 16, 2012, and include the one hundred
dollar license fee. The MTO shall also ensure
compliance with rules
4766-2-04 and
4766-2-08 of the Administrative
Code. A change in level of service does not change the expiration date of
the license.

(F)
A MTO licensed at
the intermediate or advanced life support level may apply at any time to be licensed
at a lower level. The application shall be made on a form prescribed by the
board, as published on the board's website at http://omtb.ohio.gov/Forms/Form11.pdf, dated April 16, 2012, and include the one hundred dollar
license fee. The MTO shall also ensure compliance with rules
4766-2-04 and
4766-2-08 of the Administrative
Code A change in level of service does not change the expiration date of the
license.

The board may, in compliance with Chapter 119. of the Revised
Code, suspend, revoke, or refuse to issue a license or service permit for any
of the following reasons:

(A)
Any
violation of Chapter 4766. of the Revised Code or the rules promulgated
thereunder.

(B)
Failure of the MTO
to correct violation(s) cited by the inspectors of the board or provide
sufficient documentation that MTO is correcting said violation(s) within
seventy-two hours of the date of the notification(s).

(C)
Making a false statement on the
application for a license or permit.

(D)
Fraud or deceit in obtaining or
attempting to obtain a license or permit.

(E)
Lending a license or permit or borrowing
or using the license or permit of another, or knowingly aiding or abetting such
improper use or transfer of a license or permit.

(F)
Incompetence, negligence or misconduct in
operating the licensed MTO or in providing emergency medical care to
patients.

(G)
Failure to have all
equipment required in rule
4766-2-10 of the Administrative
Code on each in-service ambulance or non-transport vehicle at all
times.

(H)
Failure to staff each
ambulance or non-transport vehicle with appropriate certified, licensed, or
emergency vehicle operator trained personnel as defined in rule 4766-2- 13 of the
Administrative Code.

(I)
Failure of
the licensed MTO to notify the board of a change of ownership within three
business days of purchase or acquisition.